<!--注册模块-->
<div class="subPage wrap nobg">

	<div class="subPageBox" style="background-color: white;">
        <!--内容区start-->
		<dl class="newstextImg2 newimg1">
			<div class="this_content">
				
			</div>
			<div class="myForm">
				<form method="post" class="form_" action="php/save.php" onsubmit="return checkForm()" id="form" enctype="multipart/form-data">
					<div class="item"> 
						<div class="flaot_div label_div">
								<label class="layui-form-label">姓名</label>
						</div>
						<div class="flaot_div input_div">
								<input type="text" id="userId" name="userId" required autocomplete="off" class="text_input">
						</div>
						<div class="flaot_div is_necessary">
								*
						</div>
					</div>
					<div class="item"> 
							<div class="flaot_div label_div">
									<label class="layui-form-label">目的地</label>
							</div>
							<div class="flaot_div input_div">
									<input type="text" id="destination" name="destination" required autocomplete="off" class="text_input">
							</div>
							<div class="flaot_div is_necessary">
									*
							</div>
						</div>
					<div class="item"> 
						<div class="flaot_div label_div">
								<label class="layui-form-label">手机号码</label>
						</div>
						<div class="flaot_div input_div">
								<input type="text" id="phone" name="phone" required autocomplete="off" class="text_input">
						</div>
						<div class="flaot_div is_necessary">
								*
						</div>
					</div>
					<div class="item"> 
						<div class="flaot_div label_div">
								<label class="layui-form-label">邮箱</label>
						</div>
						<div class="flaot_div input_div">
								<input type="text" id="email" name="email"  class="text_input">
						</div>
						<div class="flaot_div is_necessary">
							
						</div>
					</div>
					<div class="item"> 
						<div class="flaot_div label_div">
								<label class="layui-form-label">微信号</label>
						</div>
						<div class="flaot_div input_div">
								<input type="text" id="wechat" name="wechat"  class="text_input">
						</div>
						<div class="flaot_div is_necessary">
								
						</div>
					</div>
					<div class="submit_div">
						<div class="flaot_div btn_div">
							<button class="submit_btn">提交申请</button>
						</div>
						<div class="flaot_div validate_div">
								<input type="text" id="validate_code" name="validate_code" required autocomplete="off" class="text_input" placeholder="验证码">
								<img  id="validate_img"   title="点击刷新" src="/validate/captcha.php" align="absbottom" onclick="this.src='/validate/captcha.php?'+Math.random();"></img>
						</div>
					</div>
				</form>
			</div>
            <!-- list start -->
            <dt class="clear"></dt>
        </dl>
        <!--内容区end-->
    </div>
</div>
<!--注册模块-->